Public Health Committee
JOINT FAVORABLE REPORT
AN ACT CONCERNING ELECTRONIC HEALTH RECORDS AND HEALTH INFORMATION EXCHANGE.
SPONSORS OF BILL:
Public Health Committee
Sen. Martin M. Looney, 11th Dist.
Sen. Leonard A. Fasano, 34th Dist.
Rep. Theresa W. Conroy, 105th Dist.
REASONS FOR BILL:
To establish a statewide health information exchange allowing for real-time, secure access to patient health information across all provider settings. The exchange must meet all state and federal privacy and security requirements and must allow patients to access their own information. Patient participation must be voluntary and at no cost to them.
The bill requires the Department of Public Health (DPH) commissioner to issue a request for proposals to nonprofit organizations to develop and operate the exchange. Applicants must have experience operating a similar exchange for another state and must be consistent with the existing statewide health information technology plan.
Within six months after the exchange's launch, each provider with a certified electronic health record (EHR) system must connect to, and participate in the exchange. Within three years of the launch, each provider must maintain a certified EHR system and must connect to and participate in the exchange.
Additionally, the bill:
1. authorizes up to $50 million in bonding for DPH to develop and maintain the exchange, including $15 million per year in FY 16 and 17 and $10 million per year the next two years;
2. requires hospitals, as a condition of licensure, to (a) maintain a certified EHR system and (b) enable bidirectional connectivity for the exchange of certain patient records;
3. prohibits hospitals from charging fees for a provider to connect to its EHR system, unless required by federal law;
4. provides a tax credit for hospitals who donate EHR-related equipment to providers; and
5. provides a tax credit for providers implementing or upgrading their EHR system.
RESPONSE FROM ADMINISTRATION/AGENCY:
Sen. Martin M. Looney, 11th Dist., Senate Pro Tempore & Sen. Leonard A. Fasano, 34th Dist. Senate Minority Leader: Shared joint testimony supporting SB 812. The bill would set up a system to assist private practice physicians with achieving interoperability in their electronic medical records system and would encourage hospitals to use a provision in the Affordable Care Act to assist community physicians with their costs. Connecticut should move toward acquiring this system used by the state of Rhode Island.
Connecticut Department of Social Services (DSS): DSS opposes the bill. In December 2014, the State of Connecticut had received nearly $300 million through the electronic health records incentive program. Connecticut does not have an operational statewide Health Information Exchange (HIE). This proposed bill does not take into account the work that has been done to create a statewide HIE.
State of Connecticut Insurance Department: The Insurance Department is supportive of concepts that focus on insurance reforms as a means of making health insurance more accessible and more consumer focused. A more holistic approach to achieving this goal would allow Connecticut an opportunity to begin to address the medical provider side of health care reform and make health care more efficient and cost effective for its citizens. The Insurance Department also cautioned the legislature to be mindful of existing efforts to move forward in a coordinated fashion with all relevant state agencies to avoid a duplication of efforts.
Victoria Veltri, State healthcare Advocate, Office of the Healthcare Advocate (OHA): The creation of a single entity to monitor healthcare trends and inform policy and the creation of a statewide Health Information Exchange (HIE) are important step towards care, coordination and resource integration. The state must be thoughtful and understanding of the limitations that have hampered past efforts to develop an effective health information exchange system.
NATURE AND SOURCES OF SUPPORT:
Dr. Angelo S. Carrabba, Chairman of the Board, eHealthConnecticut: eHealthConnecticut supports the need for the State to develop a working health information exchange and is available to assist the State in developing the exchange.
Universal Health Care Foundation of Connecticut (UHCF): UHCF supports the bill and advised legislators to go even further with the intent of the legislation. The bill addresses short-term responses and does not achieve long-term sustainable solutions. Efforts to share health information in Connecticut have been slow to evolve despite significant federal investment.
NATURE AND SOURCES OF OPPOSITION:
Connecticut Association of Health Plans: Connecticut will soon have a comprehensive All Payer Claims Database. Financing of a Healthcare Information Technology policy should be funded by the state.
Connecticut Hospital Association (CHA): CHA supports the bills intent to achieve an affordable, meaningful, and accessible Health Information Exchange (HIE), but recommends inclusion of health information technology experts, providers, and patient advocates in the HIE development. There are portions of the bill that conflict with federal laws and are not possible to achieve at the state level. Sections 4 – 6 contradict federal laws relating to electronic health records.
Connecticut State Medical Society: There is a growing sentiment among community physicians that the uses of Electronic Health/Medical Record (EHR) systems is becoming disruptive to practices, too costly, and contribute to lower standards of patient care. Legislation should not only support and mandate the interoperability of distinct EHR systems, but also require hospitals to allow medical staff and non-employed physicians to access the hospital EHR system without barriers to access.
Jennifer Herz, Assistant Counsel, Connecticut Business and Industry Association (CBIA): CBIA supports widespread adoption and utilization of electronic health records, but are concerned with fees charged to third party payers as outlined in Section 3.
Dr. Susan Israel: Providers should not be forced to have an electronic health record (EHR) and patients should have the option to opt out of having their information on the EHR system. There is no privacy in an electronic record.
Yale New Haven Health System (YNHHS): The bill does not take into account what many hospitals are already doing to share data and provide access to healthcare agencies and community physicians. The Connecticut legislature should collaborate with hospitals and other healthcare agencies to develop and build on best practices.
Reported by: Ussawin Robin Bumpen